lindsay's journey

Part-Time Clinical Faculty

early career

Lindsay is a family physician working in Brantford Ontario. She is 6 years out of a family medicine residency. She is comfortable in her clinical skills as an office-based family physician, palliative care physician, and a long-term care physician. Her clinical practice is very busy and satisfying, but she is interested in adding another dimension to her work by doing some teaching. Having completed her latest maternity leave, Lindsay completed the process of appointment application and was appointed as assistant clinical professor (adjunct) with McMaster University within the department of Family Medicine. With the appointment letter Lindsay received a MacID.

Q1. What are some of the teaching roles a part-time clinical faculty member may play?

Check out this website for opportunities in part-time clinical faculty roles:

Q2. How do you become a community preceptor for McMaster University?

Check out this website for an introduction to faculty appointments:

There is also a collection from the Department of Surgery:

Q3. What are the expectations for an adjunct assistant clinical professor?

Request a faculty guide created by your department. For example: DFM Part time rank comparison document:

Q4. What is the difference between an adjunct and a non-adjunct professor?

Request a faculty guide created by your department. For example: DFM Part time rank comparison document:

Q5. What is the MacID? What should she do with it? Is it important?

See this page to learn more about MacID:

Lindsay started to get requests to take elective undergrad students who are looking for experience in rural family medicine. Over the following 3 years, Lindsay had a student for one or two weeks on an annual basis. Each time, she oriented the students to her practice, and they spent 2-4 weeks with her everyday. The learners were keen, curious and professional. Sometimes Lindsay taught the students about techniques in history taking and physical exams. Other times she guided them in performing minor procedures. Lindsay also works as a hospitalist on some weekends at the local hospital. She finds this work a bit more stressful; even though there are many teaching opportunities, Lindsay wonders whether she could incorporate teaching activities on these hectic shifts. Overall, Lindsay enjoys working with the students, but she wonders about how to improve her teaching skills.

Q6. How could she learn more about teaching skills in this clinical context?

An introduction to teaching at McMaster, applicable to all faculty members at McMaster, can be found here:

For new faculty members, check out Spark Podcast episode 8 (tips for junior faculty 1)

And spark Podcast episode 15 (tips for junior faculty 2)

Check out these blog series for teaching in outpatient setting:


  • Lake series: teaching in ambulatory care

  • AMEE guide 26: Teaching in ambulatory care

Check out this blog post for teaching in the ward:


Check out this podcast on teaching on the fly:

  • Teaching on the Fly: EM cases

The learners had expectations for Lindsay to review clinical topics on the fly and provide daily assessment/feedback. The program requires that Lindsay complete mid and end-of-rotation assessment forms on time. Lindsay met these requirements most of the time. Occasionally, Lindsay is asked to write a letter of reference for CaRMS match, which she finds challenging. Once, Lindsay was approached by a student interested in family medicine to do a QI project in her practice. Lindsay declined because she felt unprepared to supervise research activities.

Q7. What is MacDot?

Check out this page for more information:

Q9. How to give assessment to learners?

Check out these resources on the summative assessment of learners:

Q10. What are the resources to support research/QI activities for clinical faculty members?

Watch this video recording of the Research Supervisory Skills workshop:

Lindsay feels good about her interaction with learners. She gets along well with most and finds teaching satisfying. However, she often wonders how she measured up to other teachers. Lindsay understands that her learners do complete learner evaluations of teaching but a number of them needs to be collected before she can access them. Two years later, Lindsay received an email from her department and found a link to TES (Teaching Effectiveness Score). She read through them and found some very high scores. “Very knowledgeable, able to identify knowledge gaps and address them effectively.” She also found a couple of comments like this: “appeared to be rushed; did not have time to directly observe me taking a history”.

Q11. What are learners’ teaching evaluations?

Review this article:

Teaching eval evidence: Litzelman DK, Stratos GA, Marriott DJ, Skeff KM. Factorial validation of a widely disseminated educational framework for evaluating clinical teachers. Acad Med. 1998;73(6):688–95.

Q12. What is the purpose of the MacDOT system?

Review the rationale and more information about Mac Direct Observation Tool here:

Q13. How do you use student evaluations of teaching to improve your educational practice?

To reflect on teaching evaluations, listen to this podcast: MacPFD Spark Podcast Episode about this concept

Lindsay gets about 100 work and personal emails and 50 messages daily related to her patients. She gets periodic notification of faculty events that she is invited to attend. It is certain that Lindsay cannot possibly attend every event hosted by every group. She wonders which event would address her learning needs the most. There was a university library resource event scheduled online on an evening she was off. She attended this event and learned a few new resources to help in her clinical practice. Nonetheless, she did not know anyone who attended and wished that she could see and get to know other clinical teachers. She wonders whether it would benefit her to find a group of faculty members with similar interests to learn together.

Q15. Time management seems to be a concern of Lindsay. What tricks or tips do you have that might work to help her?

Check out this short podcast on how to avoid procrastination

Check out this one hour Youtube video on time management:

Q16. How can Lindsay find like-minded individuals in developing her role as a clinical teacher? What is a community of practice?

Today Lindsay receives an email from the office of faculty appointments. It invites her to renew her appointment. She opens the attachment and finds that her contribution hours to date were just sufficient for the same level of appointment (ACP, adjunct). She opens the renewal form and starts to fill in the blanks. She reads the question: “which faculty development events have you attended in the last 3 years, e.g. CCME”. “What is CCME?” Lindsay wondered.

Q17. What are faculty contributions? How are they measured?

Q18. Many faculty members keep a Shadow CV to account for their contributions. What is a Shadow CV?

Q19. Many faculty members keep a Shadow CV to account for their contributions. What is a Shadow CV?

She wonders whether her appointment would be in jeopardy as she has attended only one event. The next question is about which topics in faculty development would she have an interest in attending. Lindsay thought of a few topics, like how to give feedback, how to teach in a busy clinical environment, and then realized that some of these topics were already presented and she couldn’t attend. Lindsay realizes that she has a problem. She has identified some learning needs; there are resources available to address them, but she can’t seem to access them.

Q21. If I cannot attend things in person, are there alternative faculty development programs that will fit better within my schedule? Do they record events for Faculty Development? Where can I access those recordings?

Lots of resources are available on in the format of blog posts, video recordings, and podcasts. We have presented a few here within the vignettes. For the complete catalogue of free open access content, check out:


Fast-forward 10 years, Lindsay’s practice has evolved. She remains a busy office-based family physician and continues to look after patients at the retirement home. She had successfully renewed her part-time faculty appointment twice. One of her teaching colleagues retired, and she applied to become a residency primary preceptor. She now supervises a resident in family medicine most months of the year. The experience was a lot more work than she had imagined but also very rewarding.

With a resident, she finds that her clinical workload is reduced, while her teaching/mentoring responsibility has increased substantially. This was a welcome change for her. As she became more comfortable in her clinical practice and teaching, she was afforded more opportunities to reflect on her interests in education and her own continuing professional development. She has paid more attention to the university’s offerings of resources and activities and over time, became more familiar with the emails. She keeps a chat group of other residency primary preceptors on her phone to exchange ideas, share updates on the residency program. She developed a strong friendship with the other resident preceptor at her practice location, and started to attend workshops together. Contrary to her earlier experience, Lindsay feels well connected into the community of practice.

Q23. What opportunities are there in education beyond teaching?

She finds that she gravitates towards workshops and resources that targeted what she considers “non-technical skills”, or skills requisite of the CanMEDS-FM “intrinsic expert roles”. In particular, she feels that learning activities that help her improve on communication and leadership skills can have broad application in her work. She appreciates that these learning activities are often low cost, and sometimes accredited for Mainpro+, the College of Family Physicians’ CPD program certification. In addition to these benefits, Lindsay has really enjoyed the opportunities to network with colleagues at these events, whom she would otherwise rarely see. After being a faculty member for 10+ years, Lindsay feels that her university appointment as a part time clinical faculty member has paid off.

Q24. What is CanMEDS again? What about CanMEDS-FM?

Check out this resource:,

Q25. Wait… All those activities are considered skill development? What other types of areas can I develop within?

Q26. What is Mainpro+? What is the Royal College equivalent? Are the credits different?

Check out this resource:;

While enjoying her practice, teaching and learning, Lindsay ponders about the next steps in her career. As she turned 40, Lindsay experiences some mid-life and mid-career musings. Her financial advisor has highlighted that she is well-situated regarding her children’s RESPs and her own RRSPs. As her children gain independence, she finds herself free a couple of evenings a week that she could allocate to additional learning or projects. Lindsay mulls over her options and reviews several options. Should she develop herself as a local leader in education? Could she put herself forward as a candidate for the boards of her provincial college? Would she focus her practice to develop a specific clinical expertise like addiction medicine or sports and exercise medicine? Lindsay wonders about what might energize the second half of her career. She even thinks about retirement from time to time, and wonders what her legacy should be.

Q27. What sorts of considerations should I have when planning for retirement?

Review these resources on this topic:

Q28. What types of activities might I use to spice up my mid-career?

Reflect on the “Second Half of Your Career” section in Managing Oneself by Peter Drucker

late career

Lindsay turned 50 this year. Her children have moved to universities, and her clinical and teaching practices have matured. In the preceding decade, Lindsay committed her non-clinical time to developing expertise as a teacher. As she gained experience and skills, she became one of the most sought after preceptors in her program. She won a number of teaching awards as a result. With increased confidence, Lindsay put herself forward for the role of site director of the family medicine post-graduate program in Brantford. She soon realized the skills requisite to being a program leader are rather different compared to being a clinical preceptor. This year marks the end of her first term in this role and she will likely be renewed for a second term. Although she has had some challenging residents in her tenure, she succeeded in supporting the faculty preceptors in coaching them through residency.

Q32. How to integrate work and life?

Lindsay feels comfortable in the routine tasks of her current leadership role and enjoys working with her team. She still carries a full complement of patients, supervises 2 residents at any given time in addition to her administrative duties. Inadvertently, Lindsay discovered that she enjoys crafting a good presentation. When she created and gave a presentation on communication skills and leadership skills to her residents, her colleagues requested that she delivered the same presentation to groups of practicing physicians. Lindsay now has developed and perfected a series of talks on this topic, and become an invited speaker throughout all the McMaster campuses. This year, she is a featured guest speaker at McMaster University’s Annual Day in Faculty Development, and will be interviewed by the Podcast team from the Department of Family Medicine. Lindsay has found a part of her work that truly integrates her skills, her interests and her creativity. Lindsay looks forward to the best years of her career and thinks about retirement with mixed emotions. She envisions that she would reduce patient care responsibilities over time but she wants to continue to supervise residents, mentor colleagues, and stay engaged in faculty development as long as possible. “What do I still need to do? How do I know when it’s time to go?” She wonders.